American Indians face health obstacles in Indiana

INDIANAPOLIS (AP) – Thousands of American Indians living in Indiana are struggling to find health care because the state is one of only a handful in the Midwest lacking an Indian Health Service clinic that provides free health services.

The federal government pays for the health service's clinics and hospitals, but it requires that a federally recognized tribe be based in the state where the clinics are located. No such tribe is based in Indiana.

Indian Health Service spokeswoman Christine Winderlin told The Indianapolis Star (http://bit.ly/oyc5Fq ) the agency needs to concentrate its services where they reach the most people. That means American Indians in Indiana must drive to Michigan or farther for care through IHS. The closest facility is an urban clinic in Chicago that provides limited services.

Doug Poe, executive director of the American Indian Center of Indiana, said some American Indians in Indiana get jobs that provide health insurance or are covered by spouses. But many, he said, end up in temporary or seasonal jobs that offer no insurance.

Medicaid and Medicare require time to take effect.

“If you're on prescription drugs for diabetes or heart disease, there could be a gap of 90 to 120 days that you won't be able to get your medication or get to a doctor because you don't have any coverage,” Poe said.

Sally Tuttle of Kokomo, a member of the Choctaw Nation of Oklahoma, said those who do have private insurance can face cultural barriers to care, especially elders who have lived on reservations their entire lives.

“You just don't walk in and say, `Hey, take off your clothes. I'm going to examine you,”' she said. “The old ways are still working for them.”

Indiana Health Service spokesman Thomas Sweeney said caregivers at the service's clinics are either American Indians or have undergone cultural training so they can communicate effectively with American Indians.

American Indians say the absence of a health clinic in Indiana, the “Land of Indians,” is just another broken promise by the federal government. They point to centuries-old treaties signed with the government that guarantee education and health benefits in exchange for their land.

“Why should I have to stay in my home territory to receive what the treaties said that my ancestors, my kids and myself are entitled to?” Tuttle asked.

“If you're in Indiana, and you're a member of a federally recognized tribe, doesn't that mean you should be able to get services?”

The 2010 census indicates that about 18,000 people, or 0.3 percent of Indiana's population, are American Indians.

The Miami Nation of Indiana has been working to obtain federal recognition since it lost its status in 1895. Nearly 4,000 of the Miami Nation's 6,000 members live in Indiana, with most in Wabash County, tribe spokeswoman Erin Oliver said.

According to the Bureau of Indian Affairs, the Miami Nation petitioned for federal recognition in 1980 but was denied in 1992. The Department of Interior concluded the Miami Nation did not meet two mandatory criteria after the 1940s: existing as a community from historical times to the present and having a political and social influence over its members as a self-governing entity.

Oliver said the Miami Nation will continue to seek recognition.

“We've always been here, and we're not going anywhere,” Oliver said.

Poe said he will continue to push for an Indian Health Service clinic in Indiana. He said data show American Indians and Alaska Natives are 600 percent and 510 percent more likely to die of tuberculosis and alcoholism, respectively, than other Americans. They are also 189 percent more likely to die of diabetes.

He is urging the state's American Indians to participate in a survey among minorities conducted by the Indiana State Department of Health that will provide current information about the health status of American Indians in Indiana.

The survey also asks questions whether members have been denied health care, how far they have to travel to reach an Indian Health Service clinic and whether they are satisfied with the services.

Having an Indian Health Service clinic nearby would help Argentina Hayes, a Chiricahua Apache who lives in Indianapolis. She is uninsured and does not see a doctor, so she also doesn't receive medication for her diabetes. Instead, she usually takes coconut oil to bring down her sugar level.

She also has a thyroid condition and occasionally receives thyroid medicine from her son or from a friend. But she's supposed to take that medication daily. When she misses a dose, her eyes swell.

“It's only a matter of time,” Hayes said, “before that happens again.”

It shouldn't be that way, Tuttle said.

“The first people in this country, or even in this territory,” Tuttle said, “are out in the cold.”

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Information from: The Indianapolis Star, http://www.indystar.com